Objective: High dose chemotherapy supported by autologous hematopoietic stem cells transplantation (AHSCT) has developed dramaticly in recent years and become the most effective approach to improve radical treatment for the chemo-sensitive lymphoma. The purposes of this study was to evaluate the efficacy and tolerance of preparative regimen BEAC and hematopoietic reconsti- tution after high dose chemotherapy in Chinese patients with advanced and recurrent lymphoma. Methods: After confirmed complete or partial remission from conventional chemotherapy, 24 patients with advanced or recurrent lymphoma including 1 recurrent HD and 23 NHL, 16 male and 8 female with median age of 29 (13(50) years, were enrolled into this study and treated by BEAC regimen (CTX 3600(4000 mg/m2, VP-16 1200 mg/m2. BCNU 300 mg/m2 and Ara-C 1500(2000 mg/m2). 3 patients were supported by ABMT and 21 by APBSCT. Mobilization regimen for APBSCT was CTX 3500 mg/m2 + G-CSF 3.5(5 (g/kg + Dexamethasone 10 mg. Autologous hematopoietic stem cells was re-infused 24(48 h after completion of high dose chemotherapy. Results: MNC 1.3 (1.0(1.7) (108/kg and MNC 1.8 (1.0(4.4) (108, CFU-GM 5.1 (1.9(9.6) (105/kg plus CD34 + cells 2.9 (1.9(8.7) (106/kg were re-infused in the ABMT group and APBSCT group respectively. All patients obtained prompt and sustained hematopoietic reconstitution. ANC (0.5 (109/L and Pt (2.0 (109/L were at day 9 (6(17) and day 10 (0(31) respectively. 16 patients were alive with median 21 (2(69) months follow-up till end of May, 2001. 1, 2 and 3 years survival rate were 60.5%, 50.1% and 50.1%, respectively. Non-hematologic toxicity was mild and tolerable. Conclusions: High dose chemotherapy supported by AHSCT in the treatment of previously-untreated poor- prognostic and recurrent lymphoma was a safe and effective modality. Further investigation was warranted.

淋巴细胞间质性肺炎恶变为淋巴瘤1例报告并文献复习

Objective To investigate the clinical feature,diagnosis,treatment and the malignant transformation of lymphoid interstitial pneumonia(LIP).Methods The clinical data of one case with LIP malignant transformation admitted in our hospital was retrospectively analyzed and the related literatures were reviewed.Results The 62-year-old female patient was admitted to our hospital because of fatigue,progressive exertional dyspnoea and occasional left lung pain for 6 months.She was diagnosed with LIP according to pathological findings,and was found to have malignant transformation at follow-up examination 1 year later.After surgery and chemotherapy,the patient had been stable both radiographically and clinically for 5 years.Conclusion LIP is a rare disease and we have hardly ever seen its malignant transformation.High awareness of LIP malignant transformation and proper consideration in the right clinical context are prerequisites for early diagnosis,and a combination of multiple treatment modalities should be considered as a feasible treatment regimen.

骨原发性非霍奇金淋巴瘤的影像学表现特点

目的:分析骨原发性非霍奇金淋巴瘤的影像学表现特点.方法:回顾性分析25例经病理证实为骨原发性非霍奇金淋巴瘤的X线、CT和MR影像资料.25例均有完整的X线资料,21例同时作了CT检查,17例同时作了MR检查.结果:X线表现为溶骨性骨质破坏的占21例,溶骨性骨质破坏和不规则硬化相混杂者3例,X线片未见明显异常者1例,出现骨膜反应者2例,出现软组织肿块者15例.21例CT扫描中,溶骨性骨质破坏者18例,溶骨性骨质破坏与不规则硬化相混杂者3例,出现骨膜反应者6例,出现软组织肿块者17例,CT图像上软组织肿块大长径为3.0～12.5cm,平均6.7cm,相应层面骨皮质连续性中断的总长度为1.5～4.0cm,平均2.6cm.17例MR扫描中,T1WI为中等信号者13例,中、低信号混杂者4例;T2WI为中等信号者8例,高信号者2例,中高信号混杂者7例.MR图像所示的软组织肿块的大长径为3.0～15.0cm,平均7.0cm.结论:骨原发性淋巴瘤在X线和CT上以溶骨性骨质破坏为主,并以骨皮质中断的长度小而软组织肿块相对较大,骨膜反应少而轻为特征,在MR的T2WI上以中等信号和不均匀信号为主,具有一定的特征性,有助于肿瘤的诊断和鉴别诊断.

原发性鼻腔非霍奇金淋巴瘤99mTc-MIBI显像的临床初探

目的:探讨99mTc-MIBI亲肿瘤显像在原发性鼻腔非霍奇金淋巴瘤定性诊断中的应用价值.方法:经病理活检确诊的8例鼻腔非霍奇金淋巴瘤的患者进行了头颈部99mTc-MIBI早期和延迟断层显像,通过视觉判断和半定量分析,与鼻息肉及正常对照组进行比较.结果:8例非霍奇金淋巴瘤患者99mTc-MIBI早期显像均为阳性,灵敏度100%.延迟显像阳性7例,灵敏度87.5%.早期及延迟显像对鼻腔非霍奇金淋巴瘤定性诊断的特异性为70%.淋巴瘤组肿瘤/齿龈、肿瘤/腮腺、肿瘤/头皮的摄取比值与鼻息肉组及正常对照组比较差异均有显著性(P＜0.05).结论:99mTc-MIBI显像在鼻腔非霍奇金淋巴瘤的定性诊断中有较好的应用前景.

原发性上颌骨非霍奇金淋巴瘤1例

病例 女,68岁,右侧颌面部渐进性增大包块4月余.查体:右侧颌面部肿胀,可触及3.5cm×4.0cm大小包块,质地中等,压痛明显,右侧鼻腔外侧壁向内隆起,全身浅表淋巴结无肿大.肝、睥肋下未及.

脑内原发性恶性淋巴瘤1例

病例 女,60岁.阵发性头痛1年余,伴有左侧肢体乏力.体检:全身浅表淋巴结未及肿大,左侧肢体肌力较对侧差.颅神经检查(-).CT示右侧枕顶叶约5.0cm×3.9cm×4.0cm大小异常密度灶,周边呈环形厚壁稍高密度,中心为低密度区,右侧侧脑室枕角受压、移位,灶周无明显水肿(图1a).增强示:该病变呈明显环形厚壁强化,中心低密度无强化(图1b).

椎旁肌肉内非霍奇金淋巴瘤侵入椎管1例

病例男,35岁.1个月前活动后自感腰部疼痛并向左臀部放射,伴腰部活动受限.20天前左下肢疼痛明显并感活动受限及左小腿麻木感,间伴有发热,高时39.8℃.

正常成人和非霍奇金淋巴瘤患者的骨髓间充质干细胞生物学特性的比较

目的比较研究非霍奇金淋巴瘤(NHL)患者和正常成人的骨髓间充质干细胞(MSCs)的生物学特性及分化能力,为临床细胞移植提供实验依据.方法获取并分离正常成人和NHL患者的骨髓MSCs,用低血清培养液培养、传代,观察MSCs的形态和生长特性,以流式细胞仪检测其免疫表型和细胞周期,体外诱导MSCs向脂肪和骨分化,行MSCs的染色体分析,电镜观察其超微结构.结果正常成人和NHL患者的骨髓MSCs具有相似的细胞形态、生长特性和免疫表型,而且都可以向骨和脂肪分化;NHL来源的MSCs具有正常的核型和超微结构,超过90%的细胞处于静止期,未发现肿瘤细胞的特征性结构.结论从NHL患者骨髓中获取的MSCs经培养传代,与正常成人骨髓MSCs一样,具有在体外大量扩增并保持低分化状态和多向分化的能力.

人原发性胃恶性淋巴瘤裸鼠原位移植肝转移模型的建立

Background and Objective: In recent years, incidence and mortality of lymphoma are markedly increasing worldwide. However, the pathogenesis and mechanism of invasion and metastasis for lymphoma are not yet fully clarified. It is mainly due to the lack of ideal animal models, which can precisely simulate the invasion and metastasis of lymphoma in the human body. So, it is very necessary to establish a highly metastatic nude mouse model of human lymphoma. This study developed a liver-metastatic model of primary gastric lymphoma in nude mice by using orthotopic surgical implantation of histologically intact patient specimens into the corresponding organs of the recipient small animals. Methods: A histologically intact fragment of liver metastasis derived from a surgical specimen of a patient with primary gastric lymphoma was implanted into the submucosa of the stomach in nude mice. Tumorigenicity, invasion, metastasis, morphologic characteristics (via light microscopy, electron microscopy, and immunohistochemistry), karyotype analysis, and DNA content of the orthotopically transplanted tumors were studied. Results: An orthotopic liver metastatic model of human primary gastric lymphoma in nude mice (termed HGBL-0304) was successfully established. The histopathology of the transplanted tumors showed primary gastric diffuse large B-cell lymphoma. CD19, CD20, CD22, and CD79a were positive, but CD3 and CD7 were negative. The serum level of lactate dehydrogenase (LDH) was elevated [(1010.56± 200.85) U/L]. The number of chromosomes ranged from 75 to 89. The DNA index (Dl) was 1.45 ± 0.25 (that is, heteroploid). So far, the HGBL-0304 model has been passed on for 45 generations of nude mice. A total of 263 nude mice were used for the transplantation. Both the growth and resuscitation rates of liquid nitrogen cryopreservation of the transplanted tumors were 100%. The transplanted tumors autonomically invasively grew and damaged a whole layer in the stomach of nude mice. The metastasis rates of liver, spleen, lymph node, and peritoneal seeding were 100%, 94.3%, 62.6%, and 43.5%, respectively. Conclusions: The study successfully establishes an orthotopic liver metastatic model of human primary gastric lymphoma in nude mice. The HGBL-0304 model can completely simulate the natural clinical process of primary gastric lymphoma and provides an ideal animal model for the research on the biology of metastasis and antimetastatic experimental therapies of primary gastric lymphoma.

恶性血液病患者CD54表达及其与临床特征、疗效的关系

[目的]探讨细胞间黏附分子-1(CD54)在恶性血液病的表达.[方法]用免疫荧光方法检测19例急性髓系白血病,34例急性淋巴细胞白血病,10例慢性粒细胞白血病,15例多发性骨髓瘤,21例非霍奇金淋巴瘤和16例正常人骨髓单个核细胞表达CD54.[结果]①除多发性骨髓瘤、慢性粒细胞性白血病外,急性髓性白血病细胞、非霍奇金淋巴瘤、急性淋巴细胞白血病患者骨髓单个核细胞表面CD54表达低于正常人.②CD54在急性早幼粒细胞白血病(M3)表达高于在其它类型急性髓系白血病细胞表达,在T-急性淋巴细胞白血病表达明显低于B-急性淋巴细胞白血病表达.③高白细胞数、中枢神经系统白血病、脾肿大者表达水平下降(P<0.05).④CD54的表达在急性淋巴细胞白血病完全缓解组明显高于未缓解组,P<0.01.随着病情缓解CD54表达可升至正常范围.[结论]不同的恶性血液病,黏附分子CD54表达不同,并与细胞类型、临床特征及疗效有关.

BACKGROUND: A preoperative diagnosis of primary hepatic lymphoma (PHL) can have profound therapeutic and prognos-tic implications. Because of the rarity of PHL, however, there are few reports on diagnostic imaging.We reviewed the clinical and radiologic findings of 29 patients with PHL, the largest series to date, to evaluate the diagnostic features of this disease.
METHODS: Clinical data and radiologic findings at presen-tation were retrospectively reviewed for 29 patients with pathologically confirmed PHL from January 2005 to June 2013. Imaging studies, including ultrasound (US) (n=29) and contrast-enhanced computed tomography (CECT) (n=24), were performed within 2 weeks before biopsy or surgery.
RESULTS: Among the 29 patients, 23 (79%) were positive for hepatitis B virus (HBV) and 26 (90%) had a significantly ele-vated level of serum lactate dehydrogenase (LDH). There were two distinct types of PHL on imaging: diffuse (n=5) and nodu-lar (n=24). Homogeneous or heterogeneous hepatomegaly was the only sign for diffuse PHL on both US and CECT, without any definite hepatic mass. For the nodular type, 63% (15/24) of patients had solitary lesions and 38% (9/24) had multiple lesions. On US, seven patients displayed patchy distribution with an indistinct tumor margin and a rich color flow signal. CECT showed rim-like enhancement (n=3) and slightly ho-mogeneous or heterogeneous enhancement (n=14) in the arte-rial phase and isoenhancement (n=5) and hypoenhancement (n=12) in the portal venous and late phases. Furthermore, in five patients, CT revealed that hepatic vessels passed through the lesions and were not displaced from the abnormal area or appreciably compressed.
CONCLUSIONS: The infiltration type of PHL was associated with the histologic subtype. Considered together with HBV positivity and elevated LDH, homogeneous or heterogeneous hepatomegaly may indicate diffuse PHL, whereas patchy dis-tribution with a rich color flow signal on US or normal vessels extending through the lesion on CECT may be the diagnostic indicators of nodular PHL.